[Hand hygiene in intensive care].

Hand hygiene represents the main way to prevent and/or at least reduce nosocomial infection incidence. In this paper we discuss this "hot topic" through both the analysis of CDC guide lines and the data resulting from a questionnaire survey sent to health care workers, eventually corroborated by their direct observation. From literature data and our survey result analyses, we are more than convinced that the winning strategies for a slow but progressive improvement of hand washing practice and compliance are (i). using a product able to decontaminate hands very quickly and without needing water; (ii). the health care worker awareness of hand hygiene and compliance feed-back importance. From our questionnaire survey as well as from our direct observation, we found a very low (5.6%) compliance of our hospital health care workers to CDC guidelines for hand washing. This may be justified above all by ward logistical and structural problems, as only 55% of sinks are located inside patient rooms, but also because there is a lacking of knowledge of new CDC suggested practices and decontaminating products. Health care worker specific training and the choice of an alcoholic antiseptic disinfectant, allowed us to significantly increase their compliance to proper practices in hand washing and hygiene, showing their interest in such an important and delicate matter.